WORCESTER PHARMACY EFF 100111 (4166)    INSTITUTION (4)

Name Value
NAME WORCESTER PHARMACY EFF 100111
STATE MASSACHUSETTS
STREET ADDR. 1 403 BELMONT ST
CITY WORCESTER
ZIP 01604-1003
OFFICIAL VA NAME WORCESTER PHARMACY EFF 100111
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME WORCESTER VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2011-10-01 00:00:00
    STATUS:   ACTIVE
    NPI:   1528354180
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA